Dataset Information

Parent reports of children's emotional and behavioral problems in a low- and middle- income country (LMIC): An epidemiological study of Nepali schoolchildren.

ABSTRACT:

Background

As epidemiological data on child mental health in low- and middle-income countries are limited, a large-scale survey was undertaken to estimate the prevalence and amount of child emotional and behavioral problems (EBP) in Nepal as reported by the parents.

Methods

3820 schoolchildren aged 6-18 years were selected from 16 districts of the three geographical regions of Nepal, including rural, semi-urban and urban areas. We used the Nepali version of the Child Behavior Checklist (CBCL)/6-18 years as screening instrument. Comparisons of child problems between genders and between the seven largest castes and ethnic groups were carried out by analysis of variance. Prevalence was computed based on American norms.

Results

Adjusted prevalence of Total Problems was 18.3% (boys: 19.1%; girls:17.6%). The prevalence of internalizing problems was higher than externalizing problems. The mean scores of Total, Externalizing, and Internalizing problems were 29.7 (SD 25.6), 7.7 (SD 8.0), and 9.1 (SD 8.1), respectively. The Khas Kaami (Dalit) group scored the highest, and the indigenous Tharu group scored the lowest on all scales. In the Mountains and Middle Hills regions, problem scores were higher in the rural areas, whereas in the Tarai region, they were higher in the urban areas.

Conclusion

The prevalence and magnitude of emotional and behavioral problems in Nepali children were found to be high compared to findings in meta-analyses worldwide. Problem scores varied according to gender, castes /ethnic groups, and living areas. Our findings highlight the need for a stronger focus on child mental problems in a low-and middle-income country like Nepal.

SUBMITTER: Ma J

PROVIDER: S-EPMC8330921 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundTeacher reports of child emotional and behavioral problems (EBPs) are sparse in many low- and middle-income countries, especially when compared to reports from parents. Cross-informant information is pivotal to clinicians when dealing with mentally ill children. In this study from Nepal, we examined teacher reports of child EBPs, the agreement between teacher and parent reports, and how this agreement varied by type of EBP and child gender.MethodsThis cross-sectional, observational study included 3808 schoolchildren aged 6-18 years from 16 districts of Nepal. Teacher and parent reports of EBPs were measured by the Nepali versions of the Teacher Report Form (TRF) and the Child Behavior Checklist (CBCL), respectively. Linear mixed model analysis was used for group comparisons and intraclass correlations. Agreement between TRF and CBCL scale scores were analyzed using Pearson's correlation coefficient.ResultsThe prevalence of EBPs according to teacher reports was 15.4%, whereas the previous parent reported prevalence was 19.1%. Also, the mean TRF score was significantly lower than mean CBCL score for the 90 common items. Mean TRF scores for Total Problems, Externalizing Problems, and Internalizing Problems were 26.9 (standard deviation, SD 24.5), 6.1 (SD 7.2), and 7.9 (SD 7.3), respectively. Consistent with parent reports, mean TRF scores for Total Problems and Externalizing Problems were higher among boys than girls, whereas no significant gender differences were found for Internalizing Problems. Teacher-parent agreement was moderate (r = .38), and slightly higher for Externalizing Problems than for Internalizing Problems (r = .37 versus r = .34). Moderate to low correlations were found for all syndrome scales, with coefficients ranging from r = .26 (Social Problems) to r = .37 (Attention Problems). The effect of child gender on the teacher-parent agreement was significant for Internalizing Problems only, with a higher agreement for girls than for boys.ConclusionNepali teachers reported fewer child EBPs than parents. Teacher-parent agreement was moderate and varied by type of EBP and child gender. Our findings underscore the importance of obtaining information on child EBPs from both parents and teachers when evaluating and treating children in low- and middle-income countries like Nepal.